Drug firms’ payments and physicians’ prescribing behavior in Medicare Part D

Drug Firms’ Payments and Physicians’ Prescribing Behavior in Medicare Part D

In a pervasive but controversial practice, drug firms frequently make monetary or in-kind payments to medical providers. Critics are concerned that drug firms are distorting prescribing behavior away from the best interests of patients, while defenders of the practice claim that payments arise from the need to educate providers about changing drug technologies. Using two different identificatio...

Association between industry payments and prescribing costly medications: an observational study using open payments and medicare part D data

BACKGROUND While many new medications may offer advantages over existing drugs, some newer drugs are reformulations of existing products that provide little innovation or incremental benefit while driving up drug costs. Despite the lack of benefit of these medications, prescribers may be motivated by payments made by the pharmaceutical industry. The objective of the study was to determine the a...

Government Payments and Insurer Benefit Design in Medicare Part D

This paper demonstrates health insurers’ incentives to design benefits that differentially appeal to profitable enrollees and deter unprofitable enrollees in Medicare Part D. A system of diagnosis-specific payments was meant to neutralize insurer benefit design incentives by paying insurers more for the sick than for the healthy. These diagnosis-specific payments were held steady even as treatm...

Physician Payments from Industry Are Associated with Greater Medicare Part D Prescribing Costs

BACKGROUND The U.S. Physician Payments Sunshine Act mandates the reporting of payments or items of value received by physicians from drug, medical device, and biological agent manufacturers. The impact of these payments on physician prescribing has not been examined at large scale. METHODS We linked public Medicare Part D prescribing data and Sunshine Act data for 2013. Physician payments wer...

Medicare. Part D: Prescription drug coverage.